Football and concussion: The ticking timebomb…

There is an argument that America’s gun debate ended after Sandy Hook. In December 2012, Adam Lanza fatally shot 20 children and six members of staff at Sandy Hook Elementary School in Newtown, Connecticut. If that atrocity could not spark a change in gun laws, nothing could. The fight had effectively been lost.

Four years later and thousands of miles away, England’s World Cup-winning team were paraded for the 50th anniversary of their victory. If the occasion was supposed to be triumphant, it failed to strike a chord. Ray Wilson, Martin Peters and Nobby Stiles, three members of that famous team, had been diagnosed with Alzheimer’s in their sixties.

According to the Alzheimer’s Society, the number of men suffering from dementia in a normal population between the ages of 65 and 69 is one in 75. Yet here were three teammates all with the same condition. In addition, Alf Ramsey suffered with the disease before his death, while Jack Charlton admitted to suffering from periods of memory loss.

If we weren’t going to talk about the links between football and dementia when it was paraded around Wembley, then when?


It was in 2002 that an inquest confirmed that Jeff Astle’s job had killed him, his brain damaged by the repeated heading of hard, heavy leather footballs. In March 2014, Dr Willie Stewart at Glasgow’s Southern General hospital re-examined Astle’s brain and diagnosed him not with Alzheimer’s but chronic traumatic encephalopathy (CTE), a degenerative condition brought on by repeated mild brain trauma.

Fifteen years after Astle’s death, progress has been painfully slow. In March 2017, the Football Association finally invited independent researchers to submit proposals to determine whether footballers and ex-footballers are suffering disproportionately from degenerative brain injuries. That followed an excellent campaign from the Daily Telegraph, with Jeremy Wilson in particular meriting great credit for his continued work.

It remains to be seen just how exhaustive this FA analysis will be, but we can be forgiven for default cynicism. Astle’s daughter Dawn stormed out of a meeting with the PFA in March and branded chief executive Gordon Taylor an “absolute disgrace” after he evaded questions about the problem. In February, FIFA insisted that there was “no true evidence” of the effects of heading the ball or receiving blows to the head having “followed the issue for more than 15 years”.

Yet the evidence is there, both anecdotal and empirical. Speak to the family of Stan Bowles, Jimmy Hill, Bob Paisley, John Charles, Nat Lofthouse, Joe Mercer, Stan Cullis and Gerd Muller. Speak to Chris Sutton, who last week spoke of his sorrow that his Dad, Mike, will never know how his beloved Norwich City have done at the weekend and can barely recognise his own son. As John Stiles, Nobby’s son, says: “It can’t be a coincidence – it seems almost to be of epidemic proportion.”

At the University of Central London, Helen Ling has damning medical evidence. Ling and her team looked at the brains of 14 retired footballers with dementia, with post-mortem examinations carried out on six of them. CTE was identified in four of the six, the first time CTE had been confirmed in a group of retired footballers. This is no longer a question of ‘yes or no?’, but ‘how bad?’.

Football has not ignored the issue of concussion entirely. At the start of the 2014/15 season, rules were introduced so that players suffering head injuries must be assessed by a club doctor before returning to the field. Yet research of Championship players by the Journal of Sport and Health Science in 2016 found that Championship clubs are largely non-compliant with Concussion In Sport guidelines on pre-season testing, evaluation methods and rest periods.

Moreover, treating head injuries in the aftermath, but what of the issue of CTE, whereby repeated heading and repeated knocks threaten a player’s safety in later life? Our treatment of concussion and degenerative conditions is woefully inept. Football is guilty of placing a tiny plaster over a gaping head wound.


Part of the reason for the sport refusing to acknowledge the issue is a reluctance to concede culpability. Those of us who have played football regularly for a period of 20 years or more may feel uneasy about the impact our own health, but also the health of our heroes. A generation of mentally damaged former players is an uncomfortable thought. “No one in football wants to find out if football is a killer,” as Dawn Astle puts it.

To accept that football’s rules are intrinsically dangerous is to accept that they must change, yet a sanitised version of the game is seen as deeply undesirable. Our romanticised vision of ‘proper’ football – cold winds, strong tackles, battling in the air for a header – is not an image that many will find it easy to shirk, despite the dangers.

Just as damaging is the ‘man up’ culture that exists in men’s football, as in other sport. “If you’re worried about the physical side of any sport, then play chess,” was Roy Keane’s now customary parodical aggression when asked about concussion on Tuesday. The insinuation is that if you aren’t prepared to take a hit, you aren’t a real competitor. It smacks of Piers Morgan’s despicable treatment of mental illness, with “pull yourself together” considered appropriate advice. Both are deeply unpleasant and unhelpful.

There is a risk of injury in any sport, of course. Part of the joy taken in triumph, particularly in individual pursuit, is that it could so easily have been taken away at any time. Yet the desire for sporting contest cannot be allowed to dictate where we draw the lines on safety. For all the enjoyment sporting theatre provides, it isn’t worth this. The families of Sutton, Astle, Stiles and Wilson will tell you as much.


Football cannot say it was not warned. In 1994, the NFL first formed its Mild Traumatic Brain Committee, which steadfastly denied any correlation between American football and degenerative brain injuries. As late as 2004 they claimed that “NFL players have evolved to a state where their brains are less susceptible to injury”, despite strong evidence to the contrary, and in 2006 they attempted to ban the publication of conflicting reports. This was akin to the tobacco industry in the 1950s and 1960s refusing to accept the carcinogenic properties of their product.

By August 2013, the NFL were legally obliged to contribute $765 million to provide medical help to more than 18,000 former players, although they still refuse to accept legal liability. A player diagnosed with CTE can receive up to $4m in compensation. Let’s hope football’s governing bodies have been saving.

The suspicion is that football is sitting on a timebomb of the sport’s own making. The 15 years since Astle’s death could have been spent funding research and assisting those diagnosed, making changes to children’s football where appropriate. Instead, football followed its own fine tradition of burying its head in the sand.

One thing is for sure: this problem isn’t going away. Keane’s misguided opinion was in response to the immediate retirement of Ireland striker Kevin Doyle on medical advice. Doyle had been suffering repeated headaches to the point that heading the ball was becoming difficult.

The concern is not just for Doyle and the other ex-footballers mentioned above, but the thousands of players around the world still left undiagnosed and still risking their health on a daily basis. The accusation is not that football is directly killing its players, but that football’s governing bodies are dangerously ignoring the possibility.

Daniel Storey

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Jack Harrison: England U21 midfielder on life in New York and leaving Man Utd

Among the current England Under-21 squad is a man who counts Andrea Pirlo and David Villa among his team-mates and is coached by Patrick Vieira at New York City FC.

Jack Harrison was born in Stoke-on-Trent but educated in the United States, leaving Manchester United and England at 14 for a football scholarship at a boarding school in Massachusetts.

This week, he has been given his debut call-up to Aidy Boothroyd’s squad for the European Championship qualifiers against Scotland in Middlesbrough on Friday and in Andorra on Tuesday.

Here he tells BBC Sport how he found out about his inclusion, how he came to be in the US, and his experiences there.

‘I rang my mum, but she wasn’t answering…’

Harrison trained for the first time with his international team-mates on Wednesday. He last played for New York City on Sunday, a 1-1 draw at Chicago Fire. Just before the game, Vieira told him he had been called up, but he ran into a problem when he tried to share the news.

The first person I called was my mum, who was in New York, but she wasn’t answering. She knew I had a game so she was probably thinking ‘why is he calling me right now?’

I finally got on the phone about 15 minutes before I went out to warm up and said: “Mum, I have made the U21s – but I have got to go and warm up so I am off’. It was quick but exciting and we were both very happy.

‘Only one other kid had left Man Utd’

It was Harrison’s mum, Debbie, who floated the idea of moving to America, with the intention being to boost his footballing prospects as well as his education.

When my mum first introduced the idea of leaving the UK to take up a football scholarship in the States, I was really apprehensive. For a lot of the young kids in academies, they just think about making it to the first team, and in a lot of cases they don’t make it.

I’m very lucky my mum helped me to have an open mind about the idea because it was a great opportunity and about much more than the football side. There was an education there as well.

There were a lot of people who doubted the decision to leave Manchester United but I am happy that I stuck with it.

I am very thankful for my time at the club – a lot of the foundation of skills I have is mainly through them. I think they were pretty disappointed that I was leaving – only one other kid had left the academy before and that was to go on a tennis scholarship – but we left on a good note. It wasn’t hostile.

‘Vieira and Lampard have been amazing’

Last year Harrison was the number one pick in the MLS draft, eventually signing his first professional contract with New York City. Since making his debut, Harrison has played 55 times for the first team, scoring 14 goals and providing 10 assists.

When I finally got drafted by New York City FC, I realised then I had no regrets. I would definitely recommend it to any younger player who is not getting as much game time as they would like.

It has been a great opportunity to go out there and get that playing experience under your belt. I am so grateful to be in that position. With the support of New York behind me, it is really special.

Patrick [Vieira, New York City’s manager] has been amazing. He has been so supportive since drafting me. I had an injury at the time. He helped me through that a lot. Frank [Lampard, former England, Chelsea and New York midfielder] has been incredible too.

Even this past year, while he has been in England and not playing, he has reached out to me and congratulated me on a goal. Just little things like that. It might not be much to him but they mean the world to me.

City Football Group [who in addition to New York City also own Manchester City among other clubs] is an amazing organisation to be a part of. They have been so supportive of everything I have done so far. As a player, everyone dreams of playing in the top leagues in Europe. It would be a great opportunity if that was to come up.

For now, I am just focused on being at New York, finishing off the season and hopefully winning something. I will see what happens after that.

Harrison was speaking to BBC Sport’s Simon Stone

World Cup: ‘This is not Assad’s team, it’s Syria’s team’

Syrian midfielder Zaher Midani and his colleagues will have more than football on their mind in tonight’s first leg World Cup playoff against Australia.

“We have a huge motivation: to make the Syrian people happy,” Midani said. “The players and management hope we’ll be able to unify our people.

“Australia may have many big-name players known for their individual talents. But we have the enormous potential that comes from performing as a group.”

Syria have never been so close to a maiden World Cup berth.

To describe the team’s unprecedented qualifying run as improbable is an understatement.

On a shoestring budget and shackled by security concerns that deny them from hosting home fixtures on home soil, the world No75 nation has toppled several rivals that boast significantly greater pedigree and pay cheques.

It has all the trappings of a fairytale, a Cinderella story, of a country ripped to shreds by civil war finding hope in the all-uniting power of sport.

Last month, when Omar Al Somah scored a sensational stoppage-time equaliser against Iran to snatch Syria’s historic first World Cup play-off spot, thousands of jubilant fans danced on the streets of Damascus in a rare celebration.

However, that the giant public screen on which they watched was erected by president Bashar al-Assad’s dictator government underlines the very reason Syrians are so painfully divided over what their national team represents.

Detractors say the team normalises and legitimises the regime’s myriad atrocities while sweeping under the carpet the killings, disappearances and detainments of professional football players.

The government stands accused of using the team as a propaganda tool, another weapon against its own people.

The allegation was epitomised in 2015 when then Syria coach Fajr Ibrahim attended a press conference wearing a T-shirt emblazoned with Assad’s image.

They’re all factors that informed captain Firas Al Khatib’s decision in 2012 – along with teammate Somah – to boycott the national team until the country stopped bombing its civilians.

Five years later the 34-year-old – widely considered Syria’s greatest player – accepted a call to return for the Russia 2018 push, but betrayed signs of a man trapped between a grim divide.

“I’m afraid, I’m afraid,” Khatib told ESPN in May. “What happened is very complicated, I can’t talk more about these things.

“Better for me, better for my country, better for my family, better for everybody if I not talk about that. Whatever happen, 12 million Syrians will love me. Other 12 million will want to kill me.”

Indeed, when half a nation’s population is displaced, the chasm cannot expect to be fixed by a sporting team mired in such deep moral conflict.

Regardless, the unlikely success has provided welcome respite to both regime backers and opponents.

Some, like Wafi al-Bahsh, who runs a football club in the rebel-run Eastern Ghoutan near Damascus, attempt to reconcile their feelings by separating sport and politics.

“My dream is to see Syria qualify for the World Cup,” he said. “This team is not Assad’s team, it’s Syria’s team.”

Since you’re here …